Ch 34 - Coagulation Disorders

Question 1

Phases of platelets (4)

Answer 1

adhesion
aggregation
secretion
cross-linked of adjacent platelets

Question 2

Thrombogenesis (blood vessels)

Answer 2

vasocontriction
formation of platelets plugs
regulation of coagulation and fibrinolysis

Question 3

Blood coagulation (3 components)

Answer 3

extrinsic pathway
intrinsic pathway
thrombin activation

Question 4

Extrinsic pathway

Answer 4

Tissue damage exposes tissue factor

Question 5

intrinsic pathway

Answer 5

Platelets interact with damaged endothelium

Question 6

thrombin activation

Answer 6

formation of fibrin clot

Question 7

Virchow’s Triad

Answer 7

stasis (decreased BF)
hypercoagulability (blood clot are likely)
endothelial injury (damage of inside of blood vessel)

Question 8

White thrombus

Answer 8

high-pressure arteries (abnormal endothelium)
arterial flow
fibrin formation
downstream ischemia

Question 9

red thrombus

Answer 9

low-pressure veins
red cell around white thrombus
long tail
detachment
PE

Question 10

DVT risk factors (inherited)

Answer 10

anti-thrombin III deficiency
Protein C & S deficiency
sickle cell anemia
activated protein C resistance

Question 11

DVT risk factor (Acquired)

Answer 11

bedridden
surgery/trauma
obesity
estrogen use
malignancies
chronic venous insufficiency

Question 12

regulation of coagulation (2 systems)

Answer 12

Fibrin inhibition
fibrinolysis

Question 13

Protease inhibitors (4)

Answer 13

alpha 1 - antiprotease
alpha 2 - macroglobulin
alpha 2 - antiplasmin
antithrombin

Question 14

Fibrinolytic system function:

Answer 14

-Convert (inactive) plasminogen to plasmin(active)

Question 15

Thrombotic disease therapy

Answer 15

t-PA
urokinase
streptokinase

Question 16

Aminocaproic Acid

Answer 16

protect clots from lysis

Question 17

What type of thrombus is associated with a high pressure vessel (i.e. artery)?

Answer 17

White Thrombus (No RBCs, just fibrin)

Question 18

What two factors are exposed by injury leading to platelet adherence & activation?

Answer 18

-Exposed Collagen
- Von Willebrand Factor

Question 19

What type of thrombus is associated with a low pressure vessel (i.e. vein)?

Answer 19

Red Thrombus (RBC + fibrin)

Question 20

What do platelets release that. causes local vasoconstriction?

Answer 20

Serotonin

Question 21

What type of thrombus would you expect to see associated with Coronary Artery Disease? Why?

Answer 21

White Thrombus (high pressure vessel, no RBCs)

Question 22

Detachment of Red thrombi typically leads to what complication?

Answer 22

Pulmonary Embolism

Question 23

DVT risk factors can be _________ and/or _________.

Answer 23

Inherited; acquired

Question 24

What are some examples of acquired DVT risk factors?

Answer 24

Bedbound
Surgery/trauma
Obesity
Estrogen use (birth control typical)
Malignancies

Question 25

What common form of transportation is a risk factor for DVT formation? How is this prevented?

Answer 25

-Airplane flights
-Getting up, stretching, flexing lower extremities.

Question 26

What is DIC? Why does this occur?
What results from this condition?

Answer 26

-Disseminated Intravascular Coagulation
-Completely used up blood clotting factors
-Excessive spontaneous bleeding is the result.

Question 27

What are four common causes of DIC?
What are the treatments?

Answer 27

1.Massive tissue injury
2.Malignancy
3.Bacterial Sepsis
4. Abruptio Placentae

Plasma transfusion & treatment of underlying cause.

Question 28

What is the mortality of DIC?

Answer 28

10-50%

Question 29

How is overcoagulation avoided by our body’s internal mechanisms?

Answer 29

Regulation of Coagulation via:
- Fibrin Inhibition
- Fibrinolysis

Question 30

What enzyme converts plasminogen to plasmin?
What is the purpose of this conversion?

Answer 30

• tPA (tissue Plasminogen Activator)
• Plasmin actually breaks down the clot itself